PHOM Indicator Profile Report of Immunization - Influenza, Adults

Why Is This Important?

Influenza, or flu, is an acute viral infection involving the respiratory tract that can occur in epidemics or pandemics. Influenza can cause a person, especially older persons, to be more susceptible to bacterial pneumonia.
It was estimated that from 2010-2011 to 2015-2016 flu seasons, flu related hospitalizations in the U.S. ranged from 140,000 to a high of 710,000. During the 2015-2016 flu season, CDC estimated that 310,000 people were hospitalized for flu-related illnesses.^1^
The annual direct medical costs (hospitalization, doctors office visits, medications, etc.) for influenza in adults are estimated at $8.7 billion including $4.5 billion for adult hospitalizations resulting from influenza-attributable illness. Influenza is also responsible for substantial indirect costs ($6.2 billion annually), mainly from lost productivity.^2^
__References__
#Centers for Disease Control and Prevention (CDC). ''Seasonal Influenza-Associated Hospitalizations in the United States''. Retrieved from: [http://www.cdc.gov/flu/about/qa/hospital.htm]
#Centers for Disease Control and Prevention (CDC). ''Workplace Health Promotion - Adult Immunization''. Retrieved from: [http://www.cdc.gov/workplacehealthpromotion/health-strategies/flu-pneumonia/index.html]

Data Notes

In 2011, the BRFSS changed its methodology from a landline only sample and weighting based on post-stratification to a landline/cell phone sample and raking as the weighting methodology. The data for 2011 and later on this graph are based on the new methodology (landline/cell phone sample; raking).
Due to changes in both sampling and the question format, data for 2011 and later should be interpreted with caution compared to previous years.
U.S. data are the average for all states and the District of Columbia; they do not include the U.S. territories.
These rates are crude rates, not age-adjusted, given that the Healthy People 2020 Objective is based on crude rates.

Risk Factors

Risk factors for serious complications of influenza include:
* Children younger than five years, but especially younger than two years
* Adults 65 years of age and older
* Pregnant women (and women up to two weeks postpartum)
* Residents of nursing homes and other long-term health facilities
* American Indians and Alaskan Natives
* People who have chronic medical conditions including:
** Asthma
** Neurological and neurodevelopment conditions
** Chronic lung disease
** Heart disease
** Blood disorders
** Endocrine disorders
** Liver disorders
** Metabolic disorders
** Weakened immune system due to disease or medication
** People younger than 19 years of age who are taking aspirin or salicylate-containing medications
** People with extreme obesity (BMI of 40 or greater)
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__Reference__
#Centers for Disease Control and Prevention (CDC). ''Are you at High Risk for Serious Illness from Flu''. Retrieved from: [https://www.cdc.gov/features/fluhighrisk/index.html]

How Are We Doing?

The percentage of Utahns aged 65+ who received a flu vaccine is measured by the Behavioral Risk Factor Surveillance System (BRFSS) survey, and was found to be 56.0% in 2017 as compared to 54.9% in 2016.
There was a decrease in coverage rates from 2007-2010 using the old BRFSS methodology and we saw a continuation of this decreased trend in 2011 and 2012 using the new methodology that was implemented in 2011. Using the new methodology, there was an increase in coverage rates from 2013-2015. In 2016 the coverage rate decreased again, but increased in 2017. The data can fluctuate year to year, and it will be useful to look at the data in the future to see which way the trend will go.

What Is Being Done?

The UDOH Immunization Program and Office of Epidemiology educate health care providers, clinic staff, and the public about prevention methods and support investigation of outbreaks.
==Who Should Get Influenza Vaccine?==
For the 2018-2019 season, the Advisory Committee on Immunization Practices (ACIP) recommends annual influenza vaccination for everyone six months and older with any licensed, appropriate influenza vaccine with no preference expressed for any one vaccine over another. Some vaccines are not recommended in some situations and health conditions, and some people should not receive influenza vaccines at all (though this is uncommon).
===The Influenza (Flu) Shot===
====People Who can get the flu shot====
*Different flu shots are approved for people of different ages. Everyone should get a vaccine that is appropriate for their age.
*There are inactivated influenza vaccines that are approved for people as young as six months of age.
*Some vaccines are only approved for adults.
*Flu shots are recommended for pregnant women and people with chronic health conditions.
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====People who SHOULD NOT get the flu shot:====
*Children younger than six months of age are too young to get the flu shot.
*People with severe, life-threatening allergies to flu vaccine or any ingredient in the vaccine. This might include gelatin, antibiotics, or other ingredients.
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====People who should talk to their doctor before getting the flu shot:====
If you have one of the following conditions, talk with your healthcare provider:
*If you have an allergy to eggs or any of the ingredients in the vaccine. Talk to your doctor about your allergy.
*If you ever had Guillain-Barr Syndrome (a severe paralyzing illness, also called GBS). Some people with a history of GBS should not get this vaccine. Talk to your doctor about your GBS history.
*If you are not feeling well, talk to your doctor about your symptoms.
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===Nasal Spray Flu Vaccine:===
====People who can get the nasal spray flu vaccine:====
*The nasal spray vaccine is approved for use in people 2 years through 49 years of age. It is an option for healthy, non-pregnant people in this age group.
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====People who SHOULD NOT get the nasal spray vaccine:====
*Children younger than two years
*Adults 50 years and older
*Pregnant women
*People with a history of severe allergic reaction to any component of the vaccine or to a previous dose of any influenza vaccine
*Children 2 years through 17 years of age who are receiving aspirin- or salicylate- containing medications
*People who are immunocompromised
*Children 2 years through 4 years who have asthma or who have had a history of wheezing in the past 12 months
*People who have taken influenza antiviral drugs within the previous 48 hours
*People who care for severely immunocompromised persons who require a protected environment (or otherwise avoid contact with those persons for 7 days after getting the nasal spray vaccine).
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====People who should talk to their healthcare provider:====
If you have one of the following conditions, talk with your healthcare provider. He or she can help decide whether vaccination is right for you, and the select the best vaccine for you situation:
*People with asthma aged 5 years and older
*People with underlying medical conditions that can put them at higher risk of serious flu complications. These include conditions such as chronic lung diseases, heart disease, kidney disease, liver disorders, neurological and neuromuscular disorders, blood disorders, or metabolic disorders.
*People with moderate or severe acute illness with or without fever
*People with Guillain-Barr Syndrome within 6 weeks following a previous dose of influenza vaccine
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__Reference__[[br]]
Centers for Disease Control and Prevention (CDC). "Vaccination: Who Should Do It, Who Should Not and Who Should Take Precautions". Retrieved from: [https://www.cdc.gov/flu/protect/whoshouldvax.htm].

Healthy People Objective: Increase the percentage of adults aged 18 and older who are vaccinated annually against seasonal influenza

Utah DOH

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